Our understanding of dementia may need an update.
Annemari Kilpelainen, doctoral researcher at the University of Eastern Finland, tells us why.
Annemari Kilpeläinen is a neurologist at the Neurocenter of Kuopio University Hospital and a PhD researcher at the University of Eastern Finland. Her clinical interests focus on epilepsy and movement disorders, while her research centers on frontotemporal dementia (FTD) spectrum diseases.
Epilepsy in Frontotemporal Dementia
Frontotemporal dementia (FTD) is a neurodegenerative disorder primarily marked by early behavioral and language impairments. Traditionally, it has been considered mainly a cognition- and behavior-affecting disorder. However, recent findings suggest that this view may be too narrow.
New research from our team, is shining a spotlight on a less obvious but important burden of FTD: epileptic seizures. In this population-based, case-control study from Finland, we aimed to answer the following questions: how often do people with FTD experience epilepsy, compared to cognitively healthy controls and to people with Alzheimer’s disease, and when do epileptic seizures occur in the course of their disease?
The results were striking. Epilepsy was nearly five times more common in people with FTD than in the general population and more prevalent than in those with Alzheimer’s disease at all time points examined. In people who are eventually diagnosed with FTD, epilepsy becomes more prevalent already five years before the FTD diagnosis. Due to this interesting connection between these two conditions, it raises further questions of whether they share similar pathophysiological changes in the brain even before neurodegeneration becomes visible.
These results prompted us to reconceive FTD not just as a behavioral-language disorder, but as a condition where epilepsy is a more frequent comorbidity than previously recognized. Importantly, seizures often manifested early in the disease trajectory. This underscores the need for neurologists to view FTD patients through a broader lens ensuring that seizure management is accurate and timely.
In summary, epilepsy is a relevant and early-emerging feature of FTD. Recognizing this link could lead to improved diagnosis, management and understanding of the disease.
